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Organization
PROLIFIC SPEECH THERAPY LLC
Active
Organization
PROLIFIC SPEECH THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACKSON JULIEN LANWAY SLPD (BUSINESS OWNER AND PRACTITIONER)
(248) 310-0807
Entity
Organization
Contact information
Practice address
551 ALBANY ST, FERNDALE, MI 48220-3333
(248) 310-0807
Mailing address
551 ALBANY ST, FERNDALE, MI 48220-3333
(248) 310-0807
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
04/07/2025
Last updated
04/07/2025
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